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As children with SMA may have a limited carnitine synthetic capacity due to significantly diminished skeletal muscle mass, and VPA is known to inhibit carnitine transport and deplete carnitine levels by binding to VPA metabolites, we elected to combine VPA therapy with sufficient supplemental carnitine to avoid concerns about a confounding effect of carnitine depletion

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Biological & Pharmaceutical Bulletin 31 (9): 16739

Choose bland, easily digestible foods and avoid high-fat, greasy, or heavily spiced meals that may exacerbate nausea

Dobrzyska I, Szachowicz-Petelska B, Skrzydlewska E, Figaszewski Z (2010) Effect of L-carnitine on liver cell membranes in ethanol-intoxicated rats